Technology and Disability - Volume Pre-press, issue Pre-press

Authors: Teixeira, Pedro | Eusébio, Celeste | Teixeira, Leonor

Article Type: Review Article

Abstract: BACKGROUND: In the tourism industry, people with disabilities (PwD) are frequently excluded from certain activities. The Internet is one of the most used information sources for planning tourism trips. However, the level of accessibility of information disseminated by the tourism industry through websites is still very low. OBJECTIVE: This study aims to explore the existence of diversity in Web accessibility in the tourism industry. METHODS: A systematic literature review method was used for the identification, selection, and evaluation of the published research on Web accessibility in the tourism industry. A set of 40 …papers obtained from relevant scientific databases, and complemented with a snowballing effect, was synthesized and analyzed. RESULTS: Low levels of diversity of Web accessibility were found in the different tourism activities analyzed. The majority of studies published in this field are relatively recent and both manual and automated methods were employed. Web accessibility failures were mainly related to lack of connectivity with assistive technologies, complex layout, and navigation difficulties. CONCLUSION: The results obtained in this systematic literature review provide important contributions to increase knowledge of Web accessibility in the tourism industry. Moreover, practical and theoretical contributions can help Web developers creating more accessible tourism websites. Show more

Keywords: Accessible tourism, web accessibility, WCAG, tourism supply agents, technology, disability

DOI: 10.3233/TAD-210341

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-20, 2021

Authors: Lissom, Luc Oscar | Bonsangue, Valentina | Macca, Marina | Severini, Giacomo | Lavezzi, Susanna | Basaglia, Nino | Straudi, Sofia

Article Type: Research Article

Abstract: BACKGROUND: There is still no clear evidence available on the role of robot-assisted gait training (RAGT) in severe traumatic brain injury (TBI) and on the relationship between this intervention and cognitive impairment. OBJECTIVE: This study investigates the impact of the cognitive level at admission on functional recovery in a cohort of patients with severe TBI who received RAGT training within a multidisciplinary rehabilitation setting. METHODS: We included patients with gait disturbance due to a severe TBI. Patients were grouped into three classes according to their level of cognitive functioning (LCF) at admission (LCF …2-3; LCF 4-5-6; LCF 7-8). We collected demographics (sex, age), clinical data, and a set of outcome measures at admission and discharge. RESULTS: We registered 80 patients, 19 females and 61 males, 35.3 ± 14.85 years. Patients with a low cognitive level at admission were mostly subacute (p = 0.001). Cognitive impairment despite longer length stay in the hospital (LOS) (p = 0.001) did not preclude recovery after RAGT in terms of cognition (R 2 = 0.68; p < 0.0001), functional independence (R 2 = 0.30; p < 0.0001) and overall disability (R 2 = 0.32; p < 0.0001). CONCLUSION: Irrespective of their level of cognition, patients with severe TBI might benefit from RAGT during a multidisciplinary program. Show more

Keywords: Traumatic brain injury, robot-assisted gait training, cognition, multidisciplinary rehabilitation, disability

DOI: 10.3233/TAD-200324

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-7, 2021

Authors: DV, Jeevithashree | Jain, Puneet | Mukhopadhyay, Abhishek | Saluja, Kamal Preet Singh | Biswas, Pradipta

Article Type: Research Article

Abstract: BACKGROUND: Users with Severe Speech and Motor Impairment (SSMI) often use a communication chart through their eye gaze or limited hand movement and care takers interpret their communication intent. There is already significant research conducted to automate this communication through electronic means. Developing electronic user interface and interaction techniques for users with SSMI poses significant challenges as research on their ocular parameters found that such users suffer from Nystagmus and Strabismus limiting number of elements in a computer screen. This paper presents an optimized eye gaze controlled virtual keyboard for English language with an adaptive dwell time feature for …users with SSMI. OBJECTIVE: Present an optimized eye gaze controlled English virtual keyboard that follows both static and dynamic adaptation process. The virtual keyboard can automatically adapt to reduce eye gaze movement distance and dwell time for selection and help users with SSMI type better without any intervention of an assistant. METHODS: Before designing the virtual keyboard, we undertook a pilot study to optimize screen region which would be most comfortable for SSMI users to operate. We then proposed an optimized two-level English virtual keyboard layout through Genetic algorithm using static adaptation process; followed by dynamic adaptation process which tracks users’ interaction and reduces dwell time based on a Markov model-based algorithm. Further, we integrated the virtual keyboard for a web-based interactive dashboard that visualizes real-time Covid data. RESULTS: Using our proposed virtual keyboard layout for English language, the average task completion time for users with SSMI was 39.44 seconds in adaptive condition and 29.52 seconds in non-adaptive condition. Overall typing speed was 16.9 lpm (letters per minute) for able-bodied users and 6.6 lpm for users with SSMI without using any word completion or prediction features. A case study with an elderly participant with SSMI found a typing speed of 2.70 wpm (words per minute) and 14.88 lpm (letters per minute) after 6 months of practice. CONCLUSIONS: With the proposed layout for English virtual keyboard, the adaptive system increased typing speed statistically significantly for able bodied users than a non-adaptive version while for 6 users with SSMI, task completion time reduced by 8.8% in adaptive version than nonadaptive one. Additionally, the proposed layout was successfully integrated to a web-based interactive visualization dashboard thereby making it accessible for users with SSMI. Show more

Keywords: Eye tracking, virtual keyboard, assistive technology, SSMI, AAC, genetic algorithm

DOI: 10.3233/TAD-200292

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-20, 2021

Authors: Roentgen, Uta | Heide, Loek van der | Kremer, Ingrid E.H. | Creemers, Huub | Brehm, Merel A. | Groothuis, Jan T. | Hagedoren, Edith A.V. | Daniëls, Ramon | Evers, Silvia M.A.A.

Article Type: Research Article

Abstract: BACKGROUND: Impaired upper extremity function due to muscle paresis or paralysis has a major impact on independent living and quality of life (QoL). Assistive technology (AT) for upper extremity function (i.e. dynamic arm supports and robotic arms) can increase a client’s independence. Previous studies revealed that clients often use AT not to their full potential, due to suboptimal provision of these devices in usual care. OBJECTIVE: To optimize the process of providing AT for impaired upper extremity function and to evaluate its (cost-) effectiveness compared with care as usual. METHODS: Development of a …protocol to guide the AT provision process in an optimized way according to generic Dutch guidelines; a quasi-experimental study with non-randomized, consecutive inclusion of a control group (n = 48) receiving care as usual and of an intervention group (optimized provision process) (n = 48); and a cost-effectiveness and cost-utility analysis from societal perspective will be performed. The primary outcome is clients’ satisfaction with the AT and related services, measured with the Quebec User Evaluation of Satisfaction with AT (Dutch version; D-QUEST). Secondary outcomes comprise complaints of the upper extremity, restrictions in activities, QoL, medical consumption and societal cost. Measurements are taken at baseline and at 3, 6 and 9 months follow-up. Show more

Keywords: Efficiency, cost-effectiveness, impaired upper extremity function, dynamic arm supports, robotic arms, provision of assistive technology devices, user satisfaction

DOI: 10.3233/TAD-210335

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-14, 2021

Authors: Hernandez, Hamilton | Poitras, Isabelle | Fay, Linda | Khan, Ajmal | Roy, Jean-Sébastien | Biddiss, Elaine

Article Type: Research Article

Abstract: BACKGROUND: Video games can be used to motivate repetitive movements in paediatric rehabilitation. Most upper limb videogaming therapies do not however include haptic feedback which can limit their impact. OBJECTIVE: To explore the effectiveness of interactive computer play with haptic feedback for improving arm function in children with cerebral palsy (CP). METHODS: Eleven children with hemiplegic CP attended 12 therapist-guided sessions in which they used a gaming station composed of the Novint Falcon, custom-built handles, physical supports for the child’s arm, games, and an application to manage and calibrate therapeutic settings. Outcome measures …included Quality of Upper Extremity Skills Test (QUEST) and Canadian Occupational Performance Measure (COPM). The study protocol is registered on clinicaltrials.gov (NCT04298411). RESULTS: Participants completed a mean of 3858 wrist extensions and 6665 elbow/shoulder movements during the therapist-guided sessions. Clinically important improvements were observed on the dissociated and grasp dimensions on the QUEST and the performance and satisfaction scales of the COPM (all p < 0.05). CONCLUSION: This study suggests that computer play with haptic feedback could be a useful and playful option to help improve the hand/arm capacities of children with CP and warrants further study. The opportunities and challenges of using low-cost, mainstream gaming software and hardware for therapeutic applications are discussed. Show more

Keywords: Game therapy, paediatrics, cerebral palsy, haptic feedback, occupational therapy

DOI: 10.3233/TAD-200319

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-12, 2021

Authors: Santoki, Smita | Patvardhan, Neha

Article Type: Research Article

Abstract: BACKGROUND: The dominance of a digital wave is being felt in every sphere of the industry, and has been a big boon for online shoppers today. However, companies tend to ignore a section of their customer base, i.e. those who are visually impaired; although there are well-established standards set by WCAG 2.0 (Web Content Accessibility Guidelines). Although most e-commerce companies in India conform to these guidelines, as per the recommendations from the Indian government; however ironically; these are not accessible by the blind. OBJECTIVE: This paper specially focuses on the list of problems that the visually-impaired …in India face while trying to access e-commerce sites, as most of the sites haven’t conformed to the WCAG 2.0 guidelines. METHOD: Qualitative analysis through the Repertory technique by Kelly in which, the grid developed for different constructs addressing various problems faced by such users in accessing e-commerce websites. FINDINGS: From the findings, it is evident that these visually impaired people are extremely open to gaining access towards the companies’ strategies, as they also want to be a part of the main segment of the society, and would in turn be a strong contributor to the profits of the companies, if they’re taken seriously. The findings also have a series of managerial as well as social implications. CONCLUSION: Further, the study also looks at lending some suggestions through which, marketing managers would be able to look into this prevailing problem, and thereby address the same, while enhancing their level of engagement with this specially-enabled client base. This would result not only in adding profits to the business at large, but also ensure customer satisfaction and delight, albeit the fact that they’re differently abled. Show more

Keywords: Website accessibility, visually impaired, digital marketing, marketing communication gap, e-commerce

DOI: 10.3233/TAD-200293

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-7, 2021

Authors: Kumar, Shashank | Shree DV, Jeevitha | Biswas, Pradipta

Article Type: Research Article

Abstract: BACKGROUND: Web accessibility is one of the most important aspects of building a website. It is important for web developers to ensure that their website is accessible according to WCAG standards for people with different range of abilities. There is plethora of tools for ensuring conformance to WCAG standards but not many studies compared performance of automatic WCAG tools. OBJECTIVE: This paper compares a set of ten WCAG tools and their results in terms of ease of comprehension and interpretation by web developers. We proposed a Common User Profile format to help personalize contents of website …making it accessible to people with different range of abilities. METHODS: We selected ten WCAG tools from World Wide Web Consortium (W3C) to evaluate landing pages of two popular websites. For each webpage, we identified accessibility issues and recommended alternate suggestions to help developers improve accessibility. Further, we highlighted accessibility issues that cannot be captured only through conformance to WCAG tools; and proposed additional methods to evaluate accessibility through an Inclusive User Model. We then demonstrated how simulation of user interaction can capture usability and accessibility issues that are not detected through only syntactic analysis of websites’ content. Finally, we proposed a Common User Profile format that can be used to compare and contrast accessibility systems and services, and to simulate and personalize interaction for users with different range of abilities. RESULTS AND CONCLUSIONS: After careful evaluation of two websites using the ten tools, we noted that, both websites lacked color contrast between background and foreground; lack of sign language alternatives; opening of pop-ups without proper warnings and so on. Further, results from comparative analysis of selected web accessibility tools noted that, there is no single tool that can be found ideal in all aspects. However, from our study, Utilitia Validator by Utilitia SP. z O.O was considered the most feasible tool. By rectifying and incorporating issues and alternate suggestions by simulation study and Common User Profile format respectively, developers can improve both websites making it accessible to maximum audience. Show more

Keywords: WCAG guidelines, World Wide Web Consortium (W3C), accessibility evaluation tools, Cambridge Simulator, Inclusive User Model, common user profile

DOI: 10.3233/TAD-210329

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-23, 2021

Authors: Lancioni, Giulio E. | Singh, Nirbhay N. | O’Reilly, Mark F. | Sigafoos, Jeff | Alberti, Gloria | Chiariello, Valeria | Desideri, Lorenzo

Article Type: Research Article

Abstract: BACKGROUND: People with severe to profound intellectual disabilities and visual or motor impairment tend to be detached and sedentary. OBJECTIVE: The present study assessed a technology-aided intervention to promote ambulation in four people with severe to profound intellectual disability combined with blindness or deafness and spasticity. METHOD: The intervention was introduced according to a non-concurrent multiple baseline design across participants. The participants wore a smartphone fitted with the MacroDroid application at their right or left ankle. This application served to (a) detect and record smartphone’s shake events (i.e., events related to the step …responses the participant performed with the leg to which the smartphone was fixed) throughout the study, and (b) automatically deliver stimulation and encouragements/prompts (i.e., in relation to step responses and lack of responding, respectively) during the intervention. RESULTS: Data showed that during the baseline (i.e., prior to the intervention) the participants’ mean frequency of step responses were between 26 and 61 per 5-min session. During the intervention the mean session frequency increased to between 100 and 157. The increase was statistically significant for all participants. CONCLUSION: The aforementioned technology-aided intervention may be a useful tool for promoting ambulation in people like those involved in this study. Show more

Keywords: Ambulation, technology, intellectual disability, blindness, deafness, spasticity

DOI: 10.3233/TAD-210336

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-8, 2021

Authors: Myers, Edwin J. | Dominguez, David S. | Guigliano, Melissa E. | Mallory, Melissa G.

Article Type: Research Article

Abstract: INTRODUCTION: This study compared the inter-instrument reliability of the Jamar Hand Dynamometer (Jamar) to the BTE EVJ Handgrip tool (EVJ). The EVJ is a new digital handgrip instrument designed by BTE Technologies Inc. (BTE Tech) utilizing Bluetooth technology to automatically upload data to a computer or electronic health record. METHOD: This repeated measure study engaged 338 participants (N = 199 females, N = 139 males) ages 20 to 50. All participants were tested on both devices following the protocol established by the American Society of Hand …Therapists (ASHT). RESULTS: Comparative statistics included ICC values (0.81–0.84), Pearson R (correlation coefficient) (0.68–0.77), and Bland Altman plots (93–95% of data within 2 SD), indicating good inter-instrument agreement. CONCLUSIONS: The EVJ Handgrip, developed by BTE Technologies, demonstrated good inter-instrument reliability with the Jamar Hand Dynamometer and may be reliable to use when referencing the published normative values in the clinical environment. Show more

Keywords: Dynamometer, industrial rehabilitation, hand function, grip strength, functional capacity evaluation

DOI: 10.3233/TAD-200318

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-7, 2021

Authors: Kocamaz, Elif Bilsin | Akça, Kamile | Uygun, Şahin

Article Type: Research Article

DOI: 10.3233/TAD-210328

Citation: Technology and Disability, vol. Pre-press, no. Pre-press, pp. 1-8, 2021